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Glachs L, Embacher S, Berghold A, Wildner B, Michelitsch M, Tscherne A, Wedrich A, Posch-Pertl L. Treatment of myopic choroidal neovascularization: a network meta-analysis and review. Graefes Arch Clin Exp Ophthalmol 2024; 262:1693-1722. [PMID: 37950753 PMCID: PMC11106160 DOI: 10.1007/s00417-023-06271-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 06/19/2023] [Accepted: 10/07/2023] [Indexed: 11/13/2023] Open
Abstract
PURPOSE This is, to our knowledge, the first network meta-analysis aiming to compare all treatment modalities for myopic choroidal neovascularization (CNV). METHODS After the electronic databases were searched, two independent reviewers screened titles, abstracts, full-texts, and extracted information. Primary endpoints were change in visual outcome and central retinal thickness. We used a network meta-analysis to compare treatment outcomes in the early (≤ 6 months) and late (> 6 months) phase. RESULTS We included 34 studies (2,098 eyes) in our network meta-analysis. In the early phase, the use of anti-VEGF led to a gain of 14.1 letters (95% CI, 10.8-17.4) compared to untreated patients (p < 0.0001), 12.1 letters (95% CI, 8.3-15.8) to photodynamic therapy (PDT) (p < 0.0001), 7.5 (95% CI, 1.2-13.8) letters to intravitreal triamcinolone acetonide (TCA) (p = 0.019), and - 2.9 letters (95% CI, - 6.0-0.2) to the combination of anti-VEGF and PDT (p = 0.065). In the later phase, these results were largely maintained. There were no significant differences in visual outcomes between patients treated with 1 + PRN and 3 + PRN. However, the 1 + PRN group received 1.8 (SD 1.3), while the 3 + PRN group received 3.2 (SD 0.9) injections within 12 months (p < 0.0001). CONCLUSION This network meta-analysis confirms that anti-VEGF is the most effective treatment for myopic CNV using the 1 + PRN treatment strategy.
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Affiliation(s)
- Laura Glachs
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Stefan Embacher
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036, Graz, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036, Graz, Austria
| | - Brigitte Wildner
- University Library, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Monja Michelitsch
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Anna Tscherne
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Laura Posch-Pertl
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria.
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Ferreira AM, Vilares-Morgado R, Lima-Fontes M, Falcão M, Falcão-Reis F, Carneiro Â. Chorioretinal Atrophic Lesions Evolution in Patients with Quiescent Myopic Choroidal Neovascularization Followed for More Than 10 Years. Clin Ophthalmol 2024; 18:1381-1390. [PMID: 38770398 PMCID: PMC11104444 DOI: 10.2147/opth.s461515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 04/24/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose To evaluate the progression of chorioretinal atrophic areas associated with myopic choroidal neovascularization (CNV) in high myopic patients followed by a minimum period of 10 years. Patients and Methods Patients with myopic CNV lesions that achieved clinical and structural remissions over 10 years of follow-up were included. Medical records were reviewed for CNV characterization and treatment, best-corrected visual acuity at baseline (BCVA0), immediately after the last treatment (BCVA1) and at the latest visit (BCVA2). Fundus autofluorescence (FAF) was used to quantify the amount of atrophic area increase per year associated with the treated myopic CNV lesion. The first FAF performed after treatment suspension (FAF1) was compared with the most recent exam (FAF2). Results Thirty-six eyes from 36 patients were included. Mean total follow-up was 12.38 ± 2.68 years. Mean number of intravitreal injections (IVI) was 12.50 ± 12.40 and 25% of the eyes had previous treatment with photodynamic therapy (PDT). Mean improvement between BCVA0 and BCVA1 was 5.58 ± 15.98 letters (p < 0.001). However, a drop of 8.03 ± 12.25 letters was noticed between BCVA1 and BCVA2. FAF1 was 6.34 ± 4.92mm2 and increased to 9.88 ± 7.56mm2 (3.54 ± 3.79mm2 variation p < 0.001). The mean growth rate of the atrophic area was 0.89 ± 0.84mm2 per year. BCVA2 negatively correlated with FAF2 (k = -0.498, p = 0.002) being worse in patients with higher atrophic area growth rate (k = -0.341, p = 0.042). Eyes treated with PDT needed less IVI (5.89 ± 5.21 vs 14.70 ± 13.36, p = 0.008) but had larger FAF1 (9.80 ± 5.33 vs 5.19 ± 4.27, p = 0.013) and FAF2 (16.05 ± 7.10 vs 7.83 ± 6.63, p = 0.003). Hypothyroidism was associated with higher atrophy growth rate (1.55 ± 1.15 vs 0.73 ± 0.67, p = 0.016). Conclusion This research demonstrates the importance of chorioretinal atrophy progression after myopic CNV lesions regression and its impact on visual prognosis, reporting a mean yearly growth of 0.89 mm2 in atrophic areas. Previous treatment with PDT and hypothyroidism were identified as risk factors associated with larger atrophic areas and worse visual outcomes.
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Affiliation(s)
| | - Rodrigo Vilares-Morgado
- Department of Ophthalmology, Local Health Unit of São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Mário Lima-Fontes
- Department of Ophthalmology, Local Health Unit of São João, Porto, Portugal
- Department of Biomedicine, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Manuel Falcão
- Department of Ophthalmology, Local Health Unit of São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, Local Health Unit of São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Ângela Carneiro
- Department of Ophthalmology, Local Health Unit of São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine of University of Porto, Porto, Portugal
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Ma H, Wei H, Zou C, Zhu G, Gao Q, Zhang N, Wang B. Anti-VEGF Drugs in Age-Related Macular Degeneration: A Focus on Dosing Regimen-Related Safety and Efficacy. Drugs Aging 2023; 40:991-1007. [PMID: 37863867 DOI: 10.1007/s40266-023-01068-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/22/2023]
Abstract
Age-related macular degeneration (AMD) is one of the main causes of visual impairment and severe visual loss, and can progress to two advanced forms-neovascularization and atrophic. The field of anti-AMD drugs has undergone huge developments in recent years, from single-target intravitreal administration to current clinical studies with multi-target and non-invasive agents, offering interesting new pharmacological opportunities for the treatment of this disease. Hence, we summarize some of the approved anti-vascular endothelial growth factor (VEGF) drugs for neovascular AMD, especially their structural characteristics, clinical manifestations, dosing regimens, and safety issues of the anti-VEGF drugs highlighted. In addition, advances in atrophic AMD drug research are also briefly described.
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Affiliation(s)
- Haibei Ma
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hai Wei
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunpu Zou
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guoqin Zhu
- SPH Xingling Sci. & Tech. Pharmaceutical Co. Ltd., Shanghai, China
| | - Qi Gao
- SPH Xingling Sci. & Tech. Pharmaceutical Co. Ltd., Shanghai, China.
| | - Ning Zhang
- Experiment Center for Science and Technology, Shanghai University of Traditional Chinese Medicine, 1200 Cai-lun Rd, Shanghai, China.
| | - Bing Wang
- Center for Pharmaceutics Research, Shanghai Institute of Materia Medica Chinese Academy of Sciences, 501 Hai-ke Rd, Shanghai, China.
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Jain M, Narayanan R, Jana P, Mohamed A, Raman R, Verkicharla P, Padhy SK, Das AV, Chhablani J. Incidence, predictors and re-treatment outcomes of recurrent myopic choroidal neo-vascularization. PLoS One 2022; 17:e0271342. [PMID: 35862476 PMCID: PMC9302801 DOI: 10.1371/journal.pone.0271342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/28/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives To evaluate incidence, predictors, and re-treatment outcome of recurrent myopic choroidal neovascularization (m-CNV). Methods Retrospective consecutive observational series. From year 2014 to 2019, 167 eyes of 167 patients of treatment naïve m-CNV were enrolled. 59 and 108 eyes were treated with intra-vitreal ranibizumab and bevacizumab mono-therapy, respectively. Recurrence was defined as re-appearance of CNV activity, confirmed on optical coherence tomography (OCT) after at least 3 months of cessation of anti-VEGF therapy. Incidence of recurrence, predictors and re-treatment outcomes were studied. Results Overall, mean age and spherical equivalence (SE) was 47.95 ± 14.72 years and -12.19 ± 4.93 D respectively. Males constituted 50.9%. 44 eyes (26.4%) had a recurrence during a mean follow up of 16.5 ± 12.86 months. Kaplan-Meier survival analysis showed the risk of recurrence was 8, 26 and, 33.6% at 6, 12 and 18 months, respectively. Age (p = 0.511), gender (p = 0.218), SE (p = 0.092), anti-VEGF (p = 0.629) and baseline BCVA (p = 0.519) did not influence recurrence. Number of injections administered to control the disease in the first episode was the only significant predictor of recurrence (Cox Proportional Hazard Ratio 2.89–3.07, 95% Confidence Interval: 1.28–7.45; p = 0.005). At 12 months, eyes requiring one injection in first episode had a recurrence rate of 12% versus 45% in eyes requiring 3 or more injections in the first episode. A mean number of 1.9 additional injections per eye was needed during re-treatment. Final BCVA in the recurrence group was similar to that of non-recurrence group (0.53 ± 0.40 versus 0.55 ± 0.36 LogMAR; p = 0.755). Baseline BCVA (p = 0.0001) was the only predictor of final visual outcome irrespective of anti-VEGF drug (p = 0.38). Conclusion Eyes requiring greater number of injections for disease control in first episode are “at risk” of early m-CNV recurrence. However, recurrence does not adversely affect visual outcome, if treated adequately.
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Affiliation(s)
- Mukesh Jain
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Raja Narayanan
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Indian Health Outcomes, Public Health, and Economics Research Centre (IHOPE), Hyderabad, Telangana, India
- * E-mail:
| | - Priya Jana
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Ashik Mohamed
- Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Rajiv Raman
- Department of Vitreoretinal Services, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Pavan Verkicharla
- Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Srikanta Kumar Padhy
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anthony Vipin Das
- Indian Health Outcomes, Public Health, and Economics Research Centre (IHOPE), Hyderabad, Telangana, India
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, United States of America
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Chen Y, Han X, Gordon I, Safi S, Lingham G, Evans J, Li J, He M, Keel S. A systematic review of clinical practice guidelines for myopic macular degeneration. J Glob Health 2022; 12:04026. [PMID: 35356661 PMCID: PMC8939288 DOI: 10.7189/jogh.12.04026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Myopic macular degeneration (MMD) is a primary cause of blindness and visual impairment in many parts of the world. A review of clinical practice guidelines (CPGs) for intervention selection are required with the increasing demand for MMD management in clinical practice as well as in national health services. Therefore, we aim to systematically review CPGs for MMD and assist the recommendations development of the Package of Eye Care Interventions (PECI) program of the World Health Organization. Methods A systematic review of CPGs published on MMD between 2010 and April 2020 was conducted. Guidelines were evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Cochrane systematic reviews were also included when the evidence from included CPGs were inadequate or contradict. Results After applying exclusion criteria and conducting the quality appraisal, two CPGs were finally included. The average of the AGREE II ratings for the identified Guidelines were 56 and 63 respectively (7 for each item). To provide further information on interventions for MMD, one Cochrane review on MMD was additionally identified and included in the study. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs were recommended for patients with myopic choroidal neovascularization (mCNV) as first-line therapy to improve vision and reduce central macular thickness, and ranibizumab showed significant effectiveness compared to photodynamic therapy (PDT). PDT was recommended to be performed in those resistant to the treatment by one CPG but lacked of adequate description and support. Data extracted from the Cochrane systematic reviews indicated that anti-VEGF therapy for mCNV had significant effectiveness in improving visual acuity and reducing CMT compared to PDT with moderate to low certainty of evidence. Ranibizumab and bevacizumab were considered as equally effective with moderate certainty. Conclusions The outcomes of this review suggest that high quality clinical practice guidelines for MMD management are limited. Intravitreal injection of anti-VEGF agents was recommended as an effective intervention to treat myopic CNV as the first-line treatment, while there was inadequate guidance for the application of PDT in myopic CNV management. The use of other interventions for MMD were not recommended at this time and additional evidence is called for.
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Affiliation(s)
- Yanxian Chen
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Iris Gordon
- Cochrane Eyes and Vision, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Sare Safi
- Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Jennifer Evans
- Cochrane Eyes and Vision, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Jinying Li
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Mingguang He
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Stuart Keel
- Vision and Blindness Prevention Programme, World Health Organization, Geneva, Switzerland
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Kim MH, Chung YR, Song JH. Transient accumulation of subretinal fluid after half-fluence photodynamic therapy in neovascular age-related macular degeneration. BMC Ophthalmol 2021; 21:98. [PMID: 33618709 PMCID: PMC7901101 DOI: 10.1186/s12886-021-01867-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/08/2021] [Indexed: 11/22/2022] Open
Abstract
Background Photodynamic therapy (PDT) is known to occlude choroidal neovascularisation selectively, and there have been several reports on its adverse effects on the normal choroid and retinal pigment epithelium, resulting in decreased vision. Methods This retrospective interventional case series aimed to investigate the changes in visual acuity and retinal thickness in the immediate post-treatment period after half-fluence PDT, administered alone or with anti-vascular endothelial growth factor and steroids, in 29 eyes (26 patients) with neovascular age-related macular degeneration. The patients’ best-corrected visual acuity (BCVA) and central foveal thickness (CFT) on optical coherence tomography images were measured 1 day, 1 week, and 1 month post-treatment. Results Compared to the pre-treatment CFT (270.38 μm), the mean CFT was significantly increased 1 day post-treatment (387.07 μm, P = 0.001), which then started to decrease, with a mean CFT of 269.32 μm (P = 0.516) at 1 week, and of 240.66 μm (P = 0.066) at 1 month post-treatment. All CFT increases were due to the accumulation of subretinal fluid (SRF), rather than the intraretinal or subretinal pigment epithelium fluid. Relative to the pre-treatment BCVA (0.59 logMAR), the mean BCVA at 1 day (0.74 logMAR, P = 0.005) and 1 week (0.75 logMAR, P = 0.002) post-treatment was significantly deteriorated; however, it recovered to 0.62 logMAR at 1 month. The patterns of change in CFT and BCVA did not differ according to treatment modality. Conclusions Half-fluence PDT resulted in accumulation of SRF in the immediate post-treatment period; this damage mostly recovered within a week, and the BCVA was restored within a month. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01867-w.
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Affiliation(s)
- Min Ho Kim
- Allbarun Eye Clinic, Suwon, Republic of Korea
| | - Yoo-Ri Chung
- Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, 16499, Suwon, Republic of Korea
| | - Ji Hun Song
- Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, 16499, Suwon, Republic of Korea.
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LONG-TERM OUTCOMES OF RANIBIZUMAB TREATMENT OF MYOPIC CHOROIDAL NEOVASCULARIZATION IN EAST-ASIAN PATIENTS FROM THE RADIANCE STUDY. Retina 2019; 38:2228-2238. [PMID: 28961671 PMCID: PMC6221407 DOI: 10.1097/iae.0000000000001858] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A retrospective cohort study of East-Asian patients previously treated with ranibizumab for myopic choroidal neovascularization in the RADIANCE trial. Clinical charts were reviewed to assess long-term efficacy and safety. Visual acuity was sustained for additional 36 months after trial completion with few patients requiring additional treatment and no new safety concerns observed. Purpose: To evaluate long-term efficacy and safety of ranibizumab for treatment of myopic choroidal neovascularization (mCNV) in clinical practice. Methods: Noninterventional, retrospective cohort study of East-Asian patients previously treated with ranibizumab during the RADIANCE trial. Forty-one patients who completed the RADIANCE trial were followed-up for up to 48 months (post-RADIANCE observation period). Outcome measures were best-corrected visual acuity changes from baseline (assessed at RADIANCE trial initiation), mCNV recurrences, and ocular adverse events. Results: Mean visual gain from baseline best-corrected visual acuity (56.5 ± 12.1 letters) (20/80) was significant at 12 months (+14.3 ± 11.4 letters, n = 40, P < 0.0001), 24 months (+10.4 ± 22.3 letters, n = 31, P = 0.0143), 30 months (+11.0 ± 22.4 letters, n = 29, P = 0.0134), 42 months (+12.9 ± 20.9 letters, n = 25, P = 0.0051), and 48 months (+16.3 ± 18.7, n = 16, P = 0.0034). Of the 16 patients who completed 48 months of follow-up, 63% gained ≥10 letters and 13% lost ≥10 letters. Over the post-RADIANCE observation period, 83% of patients required no further treatment for mCNV, 10% experienced mCNV recurrences, and 12% experienced a nonserious ocular adverse event. Patients who required additional treatment for mCNV received a mean of 5.0 (SD 5.9, range 1.0–18.0) ranibizumab injections. Conclusion: Best-corrected visual acuity gained at the end of the RADIANCE trial was sustained over additional 36 months of follow-up. Few patients required further treatment and no new safety concerns were observed.
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Williams GOS, Euser TG, Russell PSJ, MacRobert AJ, Jones AC. Highly Sensitive Luminescence Detection of Photosensitized Singlet Oxygen within Photonic Crystal Fibers. CHEMPHOTOCHEM 2018. [DOI: 10.1002/cptc.201800028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Gareth O. S. Williams
- EaStCHEM School of Chemistry Joseph Black Building; The University of Edinburgh; Edinburgh EH9 3FJ UK
| | - Tijmen G. Euser
- Max-Planck Institute for the Science of Light Staudtstr 2; 91058 Erlangen Germany
- NanoPhotonics Centre Cavendish Laboratory; University of Cambridge; J. J. Thomson Avenue Cambridge CB3 0HE UK
| | | | - Alexander J. MacRobert
- Division of Surgery & Interventional Science; University College London; Charles Bell House London W1W 7TS UK
| | - Anita C. Jones
- EaStCHEM School of Chemistry Joseph Black Building; The University of Edinburgh; Edinburgh EH9 3FJ UK
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Kokame GT, Tom ES, Shantha JG, Kaneko KN. Polypoidal Choroidal Vasculopathy in Highly Myopic Eyes with Elongated Axial Length. Open Ophthalmol J 2018; 11:326-333. [PMID: 29299080 PMCID: PMC5725482 DOI: 10.2174/1874364101711010326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/19/2017] [Accepted: 11/02/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose: To retrospectively review the prevalence of myopia and elongated axial length in eyes with polypoidal choroidal vasculopathy (PCV) and to evaluate treatment response of PCV in highly myopic eyes. PCV has rarely been reported in myopic eyes. Methods: A retrospective review of all eyes diagnosed with PCV at the clinics of Retina Consultants of Hawaii and the Hawaii Macula and Retina Institute was performed between February of 2007 and April of 2017 to evaluate for eyes with significant myopia and elongated axial length. Results: A total of 282 eyes were diagnosed with PCV by ICG angiography. There were 144 males (59%) and 99 females (41%). 204 patients had unilateral PCV and 39 patients had bilateral PCV. A total of 3 patients with PCV had significant myopia less than -6 diopters or confirmed elongated axial length. One of these patients had bilateral PCV so there were 4 eyes noted with significant myopia and elongated axial length out of 282 eyes with PCV (1.4%). All 3 patients were Asian and presented with active leakage or bleeding related to PCV diagnosed on indocyanine green angiography and optical coherence tomography. Treatments typically used to treat PCV including intravitreal antiangiogenic medications and photodynamic therapy were utilized. Conclusion and Importance: High myopia is rare in eyes diagnosed with PCV, even though choroidal neovascularization is a common cause of vision loss in myopic macular degeneration. However, even in highly myopic eyes, PCV may show signs of resistance to antiangiogenic medications.
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Affiliation(s)
- Gregg T Kokame
- Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, 651 IIalo St. Honolulu, HI, 96813, USA.,John A. Burns School of Medicine, University of Hawaii School of Medicine, 651 Ilalo St, Honolulu, HI 96813, USA
| | - Elysse S Tom
- John A. Burns School of Medicine, University of Hawaii School of Medicine, 651 Ilalo St, Honolulu, HI 96813, USA
| | - Jessica G Shantha
- The Retina Center at Pali Momi, 98-1079 Moanalua Road, Suite 470, Aiea, HI 96701, USA.,Hawaii Macula and Retina Institute, 98-1079 Moanalua Road, Suite 410, Aiea, HI 96701, USA.,Department of Ophthalmology, Emory University, Emory Eye Center, Atlanta, Georgia
| | - Kyle N Kaneko
- The Retina Center at Pali Momi, 98-1079 Moanalua Road, Suite 470, Aiea, HI 96701, USA.,Hawaii Macula and Retina Institute, 98-1079 Moanalua Road, Suite 410, Aiea, HI 96701, USA
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CLINICAL OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS PHOTODYNAMIC THERAPY WITH OR WITHOUT BEVACIZUMAB FOR MYOPIC CHOROIDAL NEOVASCULARIZATION. Retina 2017; 37:1775-1783. [DOI: 10.1097/iae.0000000000001421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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